| Regimental number | 2421 |
| Place of birth | Nhill Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Claverton via Walbundrie, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, John Mott, Claverton via Walbundrie, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 39th Battalion, 4th Reinforcement |
| AWM Embarkation Roll number | 23/56/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A17 Port Lincoln on |